EFTA01291968.pdf

WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Currency Transaction Report Version Number 1.1 OMB No. 1506-0064 Filing Name 152-5423 9 Type of filing Z Initial report E Correctiamend prior report ❑ FinCEN directed Backfiling Document Control Number / BSA Identifier I Save Validate Print Under penalties of perjury. I declare that I have examined this transmittal, including accompanying documents, and to the best of my knowledge and belief it is correct and complete. In the case of documents without recipients identifying numbers, I have complied with the requirements of the law in attempting to secure such numbers from the receipts. I declare that this filing represents all Documents filed during this reporting period except for those transactions reported on paper. Sign with PIN SDNY_GM_00049894 CONFIDENTIAL — PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012718 EFTA_00I 60502 EFTA01291968  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part I Person Involved in Transaction 1 of 2 00 '2 Person conducting Flo Person conducting ri Person on whose behalf a- 11 ❑ transaction on own behalf b law transaction for another b I—I transaction was conducted d O Courier Service (Private) 3 O Multiple transactions Check ❑ If entity '4 Individual's last name O Unknown Indyke or entitys legal name •5 First name O Unknown Darren 6 Middle name LK. Suffix 7 Gender Male 8 Alternate Name 9 Occupation or type of business Attorney; owner of law lirm 9a NAICS Code '10 Address O Unknown 2 Kean CT '11 City O Unknown Livingston •12 State O Unknown NJ '13 ZIP/Postal Code 0 Unknown 07039 '14 Country O Unknown US •15 TIN ❑ Unknownil 16 TIN type SSN4TIN •17 Date of birth ❑ Unknowl. 18 Contact phone number Ext. 19 E-mail address '20 Form of identification used to verify identity OUnknown ig Drivers kcense/State ID O Passpon O Alien Registration O Other Number Country US Issuing State NJ 21 Cash in amount for individual or entity listed in Item 4 Account number 0 0 22 Cash out amount for Individual or entity listed in Item 4 $ 16.991 Account number [ • Page 2 of 5 SDNY_GM_00049895 CONFIDENTIAL - PURSUANT TO FED. R.QPN(F IDENTIAL DB-SONY-0012719 EFTA_00 I 60503 EFTA01291969  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part I Person Involved in Transaction 2 of 2 00 Person conducting Person conducting ro., Person on whose behalf '2 n O Courier Service (private) - transaction on own behalf b ri transaction for another c la' d transaction was conducted 3 O Multiple transactions Check O If entity '4 Individual's last name O Unknown Epstein or entity's legal name '5 First name O Unknown Jeffrey 6 Middle name Suffix 7 Gender 8 Alternate Name 9 Occupation or type of business President of SouthemElnanclal 9a NAICS Code '10 Address O Unknown 6100 Red Hook Quarter, B3 •11 City O Unknown St. Thomas •12 State O Unknown VI '13 ZIP/Postal Code 0 Unknown loc.2 '14 Country O Unknown US •15 TIN 0 Unknown 16 TIN type SSN4TIN '17 Date of birth 0 Unknown F 1112011963 18 Contact phone number Ext. 19 E-mail address '20 Form of identification used to verify identity OUnknown IX Drivers license/State ID O Passport O Mien Registration O Other Number Country US Issuing State VI 21 Cash in amount for individual or entity listed in Item 4 Account number 0 0 22 Cash out amount for IMNidlial or entity listed in Item 4 $ 16.991 Account number Page 3 of 5 SDNY_GM_00049896 CONFIDENTIAL - PURSUANT TO FED. R.QQN(F IDENTIAL DB-SONY-0012720 EFTA_00 I 60504 EFTA01291970  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part II Amount and Type of Transaction(s). Check all boxes that apply. '23 Date of transaction 12/19/2017 24 O Armored car (FI Contract) 0 ATM 0 Mail Deposit or Shipment O Night Deposit 0 Aggregated transactions '25 CASH IN: (in U.S. dollar equivalent) '27 CASH OUT: (In U.S. dollar equivalent) a Deposit(s) $ .00 a Vathdrawal(s) .00 • Payrneal(s) .00 • Advance(s) on credit (ncluding markers) .00 c Currency received for funds transkri(s) out .00 c Currency pad horn funds trans((H(s) in .00 d Purchase of negotiable instrument (s) .00 d Negotiable instrument(s) cashed 7,500,00 e Currency exchanges) 00 e Cunonry exchango(s) 9,491.00 Currency to prepaid access .00 f Currency horn prepaid access .00 g Purchases of casinos Gilts, tokens a Redempien(s) ot casino chips. tokens. and other gaming instruments 00 TITO tickets end other earning instruments 00 h Currency wager(s) ncluding h Payments) on war(s) (Inducing race ninny PleYs .00 and OTB or scats pool) .00 Travel and complimentary expenses and I Bills inserted inlo gang devices .00 took gaming Incentives .00 Payment for tournament. contest or other • Other (specify): promotions .00 .00 Z Other (specify) .00 Total Cash in .00 Total Cash Out 15,99100 26 Foreign Cash in Foreign Country O 0 28 Foreign Cash out 7,000 Foreign Country BE O 0 Page 4 of 5 SDNY_GM_00049897 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012721 EFTA_00I 60505 EFTA01291971  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part III Financial Institution Where Transaction(s) Takes Place 1 of 1 0 0 17 Type of financial institution Depository institution Other (specify) /9 Primary federal regulator Federal Reserve Board (FRB) 38 If 37a - Casino/Card Club is checked, indicate type (chedc only one) ❑ State licensed casino Tribal authorized casino Card dub ❑ Other '30 Legal name of financial institubon I Deutsche Bank Trust Company Americas 31 Alternate name, e.g. trade name, DBA 12 EIN *33 Address 346 Park Ave '34 City New York *35 State NY '36 2IP Code I10154 39 Financial institution ID type ID number '40 Contact ofhte DB PB AML '41 Phone number Ext. '42 Date Filed (Dale filed wal be auto -populated when la, form is signed.) Page 5 of 5 SDNY_GM_00049898 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012722 EFTA_00I 60506 EFTA01291972